TSH Level

[Georgiek111]

Hi everyone, I have just had my routine blood test and my results have come back with a very high level of TSH - 33.600 with reference range 0.270 - 4.200. My level is usually between 0.400 and 0.600. I have absolutely no unusual symptoms, feel exactly as I always have, no change in medication, 100mg per day. Is it even possible to have a TSH this high or is something not right with this result? TIA

[SlowDragon Administrator]

Not had change in brand of levothyroxine?

Any recent antibiotics?

Have you recently had Covid?

Suggest you get FULL thyroid and vitamin testing done in few weeks

Via GP or privately

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[Georgiek111 in reply to SlowDragon]

Thanks for the information, I will go back to GP to discuss further.I've had no change of brand since June 2019, no antibiotics, no Covid.Fasted blood test taken at 8am with Levo not taken since day before.

The number seemed off the scale silly especially with no symptoms, I wondered if perhaps the decimal point had been put in the wrong place!

[SlowDragon Administrator in reply to Georgiek111]

Next step is to get retested and more extensive tests

[jammygirl18]

Hi Georgiek111, have you had any more news? i got my bloods results from December when i was on 100mcg of levo, my TSH was 70.10, feeling pretty terrible and waiting on my blood test results from Monday past.

[Georgiek111 in reply to jammygirl18]

Hi, spoke to doctor and had a second blood test, the result was worse TSH is now 51. T4 is on the limit of too low and T3 is low. Increasing dose and retesting in 8 weeks. I havent had blood tests as frequently because of covid and doctor suspects dose has been a bit under for a while but my body has been compensating. In the last week it so I have started to feel very tired and have been struggling to lose weight for months so clues were there. What are your next steps?

[jammygirl18 in reply to Georgiek111]

im waiting on my blood tests coming back today hopefully, im extremely tired, falling asleep all the time and have swelling in my neck to the point it is starting to hurt when i speak, my memory is terrible and my joints are stiff (Im 28 years old), after coming on this forum, just out of curiosity i asked my GP surgery for a copy of my blood test results from December and this is how i realised my TSH was over 70. you seem to be the only post i can find with TSH extremely high, i was just told that my levels are off, only diagnosed from last july. i feel pretty terrible and everyday is getting worse, how are you feeling?

[Georgiek111 in reply to jammygirl18]

I had been feeling ok until very recently. I have had this for over 20 years so usually very stable. Was quite surprised to see the results. They included T4 with my retest which was borderline ok which would explain why I don't feel too awful. I'm not surprised you feel terrible with your TSH so high, dud they include T4 with your tests?Basically your body is trying very hard to get your thyroid to work and failing. I have seen people with much higher levels than us so don't panic. The next step after your blood will most logically be an increase in dose. Last me know how your blood tests are when you get them.

[jammygirl18 in reply to Georgiek111]

my T4 level was 8.4pmol/L with a range of (12-22), my b12, folate, iron, transferrin and ferritin are all normal, fingers crossed i get these results, its pretty unbearable at the minute.

[Georgiek111 in reply to jammygirl18]

Everything is pointing to you needing an increased dose, as slowdragon said usually increment is 25 a day and then retest in 6-8 weeks

[SlowDragon Administrator in reply to Georgiek111]

Well some people need much higher doses of levothyroxine

First step is to get 25mcg dose increase in levothyroxine

Which brand of levothyroxine do you take?

Make sure 25mcg tablets are same brand

Request GP test vitamin D, folate, ferritin and B12 plus coeliac blood test too

Do you have autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies?

Roughly what age are you?

[Georgiek111 in reply to SlowDragon]

Thanks and yes I agree, I was replying to someone's query. My dose has been increased by GP by 25 per day, I have hashi's, been given vit D supplement. I'm 50 and was diagnosed 10 years ago. We will retest in 8 week. I live in France and there has been a lot of controversy over Merck who changed ingreduents in Levo. If in 8 weeks there us no improvement I will discuss this with GP. Thanks

[SlowDragon Administrator in reply to Georgiek111]

I thought Merck were forced to bring back original levothyroxine as an option

New formula contains mannitol and this changes gut biome

bmj.com/content/360/bmj.k714

As you have Hashimoto’s are you already on gluten free diet?

How low was vitamin D?

[Georgiek111 in reply to SlowDragon]

Yes they have brought it back but only until the end if this year so sooner or later it will be necessary to find an alternative. I decided a year or so ago to switch, I'm fairly sure there isnt a link but its another avenue to consider if the dose increase doesn't work. I am in perimenopause, and I suspect your right that this may be part of the problem having been stable for years! Vit D was 35 with a low reference range of 75. Historically my vit D has always been a bit rubbish

Never done gluten free.... I like bread too much

[SlowDragon Administrator in reply to Georgiek111]

So vitamin D is dire

Likely B12 and folate are too.

Vitamin D

In U.K. GP will often only prescribe to bring levels to 50nmol.

Not sure what guidelines are in France

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to Georgiek111]

Also common for levels to go haywire at menopause

[Internalshaker in reply to Georgiek111]

So frustrating! At Christmas mine went to a 93! It's taken 6 weeks to get to 9.... I wake myself up at 6am to take hours before Anything else is in my system, food vitamins, such a struggle! Hang in there and keep being proactive!!!